Semi-Annual Report for period ending April 30, 2004, with
Cumulative Summary for period November 24, 2000 to April
30, 2004
Introduction:
This is the first report prepared following the completion of the pilot project phase and acceptance of the Mental Health Court as a permanent program of the Provincial Court of New Brunswick in Saint John on November 14, 2003.
During the three-year development phase of the model, a great deal of useful and important data on the operation of the Court was gathered. It was decided that a cumulative summary with data from the inception of the pilot project to date would be appropriate and beneficial to provide an overview of the court’s operation.
Evaluation:
Ever present is the need for evaluation. In this regard, we were pleased with the recent decision of the Medical Research Fund of New Brunswick to fund a unique evaluation study of the Court. The application for the funding was initiated by the principal researcher, Dr. Vinod Joshi, (Consultant Psychiatrist, Community Mental Health Center), and researchers Dr. Pamela Forsythe (Consultant Psychiatrist, Community Mental Health Center) and Dr. Abraham Punnan (Professor, Department of Mathematics, University of New Brunswick Saint John). The one-year study will address development of scientific evaluation procedures for accused persons participating in the Mental Health Court. It will compare mental health outcomes, legal outcomes and quality of life outcomes of mentally ill accused who participate in the Court with those who do not.
( www.gnb.ca/0391/MedicalResearch-e.asp )
The study was approbated by the Ethics Committee of the Atlantic Health Science Corporation and was commenced in March 2004. This will be an important study the results of which will allow health and justice personnel to gain insight into the efficacy of the Mental Health Court.
Preliminary work for this type of study was completed last year with the financial assistance of The Greater Saint John Community Foundation
( www.saint-john-foundation.nb.ca)
The Mental Health Court Team:
The team members continue to demonstrate that high level of commitment and enthusiasm for the Mental Health Court program needed to produce the results achieved to date.
(a) Judge
In January 2004, the Hon. Judge David Walker from the Provincial Court of New Brunswick in St. Stephen, presided over a sitting of the Court, providing leave relief to the presiding Judge Alfred Brien. Judge Walker has indicated an interest and willingness to assist the court by sitting at various times when needed.
(b) Crown Prosecutor
In April 2004 Mrs. Lucie Mathurin-Ring joined the Mental Health Court Team as Crown prosecutor. She replaces Mr. Steven Hinkley, who, together with his predecessor, the late Philip Holland, helped develop the role of crown prosecutor within the Mental Health Court model.
In March, the Community Mental Health Center, Saint John, presented to the Mental Health Court Team a day long session condensing the Journey of Hope. This valuable educational session, under the direction of Ms. Judith Armstrong, exposed the team to many facets of mental illness and presented an opportunity to learn first hand from those involved in mental health treatment. (http://www.ahsc.health.nb.ca/mentalhealth/saintjohnservices.shtml )
(d) Presentations
On invitation, presentations on the Court and its operation were made by Judge Brien in February 2004 at the Mid-winter Education Meeting of the Provincial Court Judges Association of New Brunswick and at Speakers Hour of the Law Students of the University of New Brunswick Law School in Fredericton.
(e) Upcoming Events
In July 2004, Judge Brien and Dr. Joshi will present a workshop on the Court at the National Annual Meeting of the Canadian Mental Health Association (N.B.) and the Schizophrenia Society (N.B.) entitled “Honouring our Past, Charting Our Future”
(www.cmhanb.ca/files/program.pdf )
Following are some updates from the report of November 14,2003.
The Mental Health Court continues to sit every second Friday in Courtroom No. 3, 15 Market Square, Saint John, New Brunswick. Pre-appearance conferences of the Mental Health Court Team commence at 12:30 P.M. and the court sits at the conclusion of the conference. While pre-appearance conferences are not open to the public, as with all sittings of the Provincial Court, the court proceedings are open.
In the past six months there have been 14 sittings of the Mental Health Court. The cumulative total is now 85 sittings over 3 ½ years.
(b) Mental Health
The Court continues to handle cases of mental illness and intellectual disability. While the majority of cases handled involve a diagnosis of major mental illness (e.g. schizophrenia, psychotic disorder, bipolar disorder, major depression disorder, ) the Court successfully tested its model in a case involving personality disorder. This was a significant challenge for both the Mental Health Court Team and the accused, requiring a monitoring period of 18 months.
On a cumulative reporting basis, of the 78 cases handled by the Mental Health Court to date, 54 or 70% are males and 24 or 30% are females.
Participants ranged in age from 18 to 67 years of age
(d) Caseload
While the majority of cases handled by the Court are from the Saint John area, the Court continues to take referrals from courts outside of Saint John. To date referrals have been made from Provincial Courts sitting in Hampton, St. Stephen and Fredericton.
The following is a cumulative summary of the cases handled for the period November 24,2000 to April 30,2004.
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Total Number of Cases presented and dealt with by the M.H.C. 78
Active Cases[1] as of April 30, 2004 19
Number in Admission Phase (in eligibility or compliance stage) 07
Number in Program Phase (accepted into and taking a program) 12
Closed Cases[2] as of April 30,2004 59
Number found unfit to stand trial or not criminally responsible 9
Number found to be ineligible for program 8
Number removed from program - in Admission Phase 2
- in Program Phase 1
Number of voluntary withdrawals - in Admission Phase 4
- in Program Phase 1
Number who successfully completed program and Graduated 35
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(e) Graduation Rate
We continue to experience a high retention rate of accused in the program. The cumulative experience is:
Number of cases admitted into Program Phase 48
Number of cases who graduated 35
It will be observed from the above figures that 73% of those accused who were admitted to the Program Phase have successfully completed the program and graduated.
(f) Post Graduation:
While it is to be expected that the nature and progression of some mental illnesses, together with external influences will cause some graduates to re-offend, the cumulative experience shows a relatively high and stable percentage who do not re-offend after graduating from the Court program:
Number who graduated and have not re-offended[3] 24
Number of second entries who graduated and have not re-offended [4] 7
Of those who did graduate from a program, 70% did not re-offend. As detailed in note 4, some allowances were made in the early stages of the pilot project. It is noted that two individuals currently in the Program Phase have been admitted two times before.
Overall, 75% of those who were readmitted to the program and graduated, have not re-offended thereafter.
Program duration is dependant upon a number of complex factors (outlined in “How does an accused graduate?” in FAQ’s) . It varies with each individual case. The Court continues to experience that longer program durations increase the chance that the graduate will not re-offend. The average program duration is between 7 and 12 months.
(h) Use of Incarceration
The Court continues to work to the goal to reduce the criminalization of and the use of incarceration for the mentally ill and intellectually disabled. In the past 6 month period, remand to jail was used in only 1 case. It involved a breach of an undertaking given to the Mental Health Court and the remand was until the next sitting of the Court.
[1] A case is classified as ‘active’ if currently in either the Admission or the Program Phase.
[2] A case is classified as ‘closed’ if no longer in either the Admission or Program phase ( i.e. on graduation, withdrawal, removal, or a finding of “unfit to stand trial”.
[3] Of this number: 3 graduated in 2001, 5 in 2002 and 12 in 2003
[4] In the early stages of the pilot, while in the process of determining program duration and defining successful completion, some accused were graduated within 3 or 4 months and then re-offended. Learning that this duration was too short and that program duration is an important factor in success, these accused were allowed to enter a program for the second time.